| 3 | 英国国家医疗服务体系实施医患共同决策显示文摘格林·埃尔温(Glyn Elwyn)和他同事认为,在让患者选择他们的治疗方案之前,首先应创建一个可以为医生和患者提供信息的工具平台。在美国、加拿大和英国,促进医患共同决策的政策正日益受到关注1-3。究其原因,一部分是认识到让患者适当参与自己的医疗决策是极其重要的伦理要求45,一部分是为了积累能够证明治疗对患者有益的证据。共同决策是临床医生和患者利用现有的最可靠证据共同做出临床决定的一种方法。医生鼓励患者考虑现有的筛查、治疗或管理方案,权衡每种方案可能的利弊,这样他们才能表达出自己的喜好,有助于为自己做出最佳选择。共同决策既体现了对患者自主性的尊重,也推动了患者积极参与临床诊疗。 | 梁立智(译) Glyn Elwyn Steve Laitner Angela Coulter Emma Walker Paul Watson Richard Thomson | 2014 | 英国医学杂志中文版2014，17，S01： | 0 |
| 4 | Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID- 19 pandemic显示文摘Background During the COVID-19 pandemic,decreased volumes of stroke admissions and mechanical thrombectomy were reported.The study’s objective was to examine whether subarachnoid haemorrhage(SAH)hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.Methods We conducted a cross-sectional,retrospective,observational study across 6 continents,37 countries and 140 comprehensive stroke centres.Patients with the diagnosis of SAH,aneurysmal SAH,ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases,10th Revision,codes.The 3-month cumulative volume,monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before(1 year and immediately before)and during the pandemic,defined as 1 March-31 May 2020.The prior 1-year control period(1 March-31 May 2019)was obtained to account for seasonal variation.Findings There was a significant decline in SAH hospitalisations,with 2044 admissions in the 3 months immediately before and 1585 admissions during the pandemic,representing a relative decline of 22.5%(95%CI−24.3%to−20.7%,p<0.0001).Embolisation of ruptured aneurysms declined with 1170-1035 procedures,respectively,representing an 11.5%(95%CI−13.5%to−9.8%,p=0.002)relative drop.Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations,a 24.9%relative decline(95%CI−28.0%to−22.1%,p<0.0001).A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1%(95%CI 32.3%to 50.6%,p=0.008)despite a decrease in SAH admissions in this tertile.Interpretation There was a relative decrease in the volume of SAH hospitalisations,aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic.These findings in SAH are consistent with a decrease in other emergencies,such as stroke and myocardial infarction. | Thanh N Nguyen Diogo C Haussen Muhammad M Qureshi Hiroshi Yamagami Toshiyuki Fujinaka Ossama Y Mansour Mohamad Abdalkader Michael Frankel Zhongming Qiu Allan Taylor Pedro Lylyk Omer F Eker Laura Mechtouff Michel Piotin Fabricio Oliveira Lima Francisco Mont'Alverne Wazim Izzath Nobuyuki Sakai Mahmoud Mohammaden Alhamza R Al-Bayati Leonardo Renieri Salvatore Mangiafico David Ozretic Vanessa Chalumeau Saima Ahmad Umair Rashid Syed Irteza Hussain Seby John Emma Griffin John Thornton Jose Antonio Fiorot Rodrigo Rivera Nadia Hammami Anna M Cervantes-Arslanian Hormuzdiyar H Dasenbrock Huynh Le Vu Viet Quy Nguyen Steven Hetts Romain Bourcier Romain Guile Melanie Walker Malveeka Sharma Don Frei Pascal Jabbour Nabeel Herial Fawaz Al-Mufti Atilla Ozcan Ozdemir Ozlem Aykac Dheeraj Gandhi Chandril Chugh Charles Matouk Pascale Lavoie Randall Edgell Andre Beer-Furlan Michael Chen Monika Killer-Oberpfalzer Vitor Mendes Pereira Patrick Nicholson Vikram Huded Nobuyuki Ohara Daisuke Watanabe Dong Hun Shin Pedro SC Magalhaes Raghid Kikano Santiago Ortega-Gutierrez Mudassir Farooqui Amal Abou-Hamden Tatsuo Amano Ryoo Yamamoto Adrienne Weeks Elena A Cora Rotem Sivan-Hoffmann Roberto Crosa Markus Möhlenbruch Simon Nagel Hosam Al-Jehani Sunil A Sheth Victor S Lopez Rivera James E Siegler Achmad Fidaus Sani Ajit S Puri Anna Luisa Kuhn Gianmarco Bernava Paolo Machi Daniel G Abud Octavio M Pontes-Neto Ajay K Wakhloo Barbara Voetsch Eytan Raz Shadi Yaghi Brijesh P Mehta Naoto Kimura Mamoru Murakami Jin Soo Lee Ji Man Hong Robert Fahed Gregory Walker Eiji Hagashi Steve M Cordina Hong Gee Roh Ken Wong Juan F Arenillas Mario Martinez-Galdamez Jordi Blasco Alejandro Rodriguez Vasquez Luisa Fonseca M Luis Silva Teddy Y Wu Simon John Alex Brehm Marios Psychogios William J Mack Matthew Tenser Tatemi Todaka Miki Fujimura Roberta Novakovic Jun Deguchi Yuri Sugiura Hiroshi Tokimura Rakesh Khatri Michael Kelly Lissa Peeling Yuichi Murayama Hugh Stephen Winters Johnny Wong Mohamed Teleb Jeremy Payne Hiroki Fukuda Kosuke Miyake Junsuke Shimbo Yusuke Sugimura Masaaki Uno Yohei Takenobu Yuji Matsumaru Satoshi Yamada Ryuhei Kono Takuya Kanamaru Masafumi Morimoto Junichi Iida Vasu Saini Dileep Yavagal Saif Bushnaq Wenguo Huang Italo Linfante Jawad Kirmani David S Liebeskind Viktor Szeder Ruchir Shah Thomas G Devlin Lee Birnbaum Jun Luo Anchalee Churojana Hesham E Masoud Carlos Ynigo Lopez Brendan Steinfort Alice Ma Ameer E Hassan Amal Al Hashmi Mollie McDermott Maxim Mokin Alex Chebl Odysseas Kargiotis Georgios Tsivgoulis Jane G Morris Clifford J Eskey Jesse Thon Leticia Rebello Dorothea Altschul Oriana Cornett Varsha Singh Jeyaraj Pandian Anirudh Kulkarni Pablo M Lavados Veronica V Olavarria Kenichi Todo Yuki Yamamoto Gisele Sampaio Silva Serdar Geyik Jasmine Johann Sumeet Multani Artem Kaliaev Kazutaka Sonoda Hiroyuki Hashimoto Adel Alhazzani David Y Chung Stephan A Mayer Johanna T Fifi Michael D Hill Hao Zhang Zhengzhou Yuan Xianjin Shang Alicia C Castonguay Rishi Gupta Tudor G Jovin Jean Raymond Osama O Zaidat Raul G Nogueira SVIN COVID-19 Registry,the Middle East North Africa Stroke and Interventional Neurotherapies Organization(MENA-SINO),Japanese Society of Vascular and Interventional Neurology Society(JVIN) | 2021 | Stroke & Vascular Neurology2021，6，4： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员